March 2021

Developing Network Adequacy Standards for VA Community Care

Health Services Research

In an article for Health Services Research, Faegre Drinker Consulting Principal Mike Adelberg — along with seven co-authors — analyzed how the U.S. Department of Veterans Affairs (VA) should develop and implement network adequacy standards. The authors also shared recommendations from national leaders regarding network adequacy standards for VA Community Care and detailed how these were incorporated into VA Community Care Network (CCN) contracts.

The authors held a panel discussion on CCN adequacy and how VA might implement network adequacy standards for community care. The nine panelists further highlighted opportunities and challenges when implementing network adequacy standards.

The five highest-ranked standards the panel identified were:

  1. Network directories for veterans
  2. Regular reporting of network adequacy data to VA
  3. Maximum wait time/distance standards
  4. Minimum ratio of providers to enrolled population
  5. Qualitative assessments of network adequacy

In conclusion, the authors stated, “The expert panel shed light on priorities for network adequacy to be implemented under CCN contracts, such as developing comprehensive provider directories for veterans to use when selecting community providers.” However, questions remain about “whether the VA could reasonably develop and implement network adequacy standards given current Congressional restraints on VA reimbursement to community providers.”

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